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General NPI Number Information
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NPI Number | 1750363388
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Entity Type | Individual
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Provider Name | PAUL KWOK-MING CHU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 130 THEODORE FREMD AVE APT M2
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City | RYE
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State | NY
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Zip | 10580-6813
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Country | US
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Telephone | 914-967-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 130 THEODORE FREMD AVE APT M2
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City | RYE
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State | NY
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Zip | 10580-6813
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Country | US
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Telephone | 914-967-0000
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Fax | 914-967-0149
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 051556-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 50231
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License Number State | CA
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